Long Term Starvation

You're talking weeks or a few months, not years, right? I would look up accounts of people who were stranded somewhere inhospitable, like the the 1972 Andes plane crash survivors, who spent 72 days in the mountains. There are various books about them, including one by survivor Nando Parrado, which might get into the details of their recovery. Apparently, only a few of them were held in the hospital for more than a day or two. They did have their dead to eat, true, but Parrado reports losing 40 kilos (88 pounds) during the ordeal, so they were definitely starving.

If you mean true long-term starvation, look for accounts by survivors of POW or concentration camps.

I read a book called Starvation Heights, the true account of a doctor that prescribed starvation therapy to her patients. She took in two rich sisters, one of whom died, and went to trial for her murder. Very interesting stuff. I believe the surviving sister took at least a year to recover.

Euphoric Mania said:

Yeah, maybe two months, not for much longer. Three weeks appears to be considered severe starvation. While the science is interesting, the healing is more important at the moment.

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Two months is getting toward the limit, so it probably would take a few days for the starving people to get their strength back. But, if there is nothing else wrong with someone, then they'd just have to take it easy for a few days while they got enough strength back to be able to get around normally.

King Neptune said:

Two months is getting toward the limit, so it probably would take a few days for the starving people to get their strength back. But, if there is nothing else wrong with someone, then they'd just have to take it easy for a few days while they got enough strength back to be able to get around normally.

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Normally, yes. But after a period of starvation like that, they will lose a lot of muscle mass. Don't expect anybody to be in the same physical shape they were in before the starvation happened until after they've had a chance to rebuild muscle.

(I know that's not what you meant, Neptune. Just expanding your answer.)

Taejang said:

Normally, yes. But after a period of starvation like that, they will lose a lot of muscle mass. Don't expect anybody to be in the same physical shape they were in before the starvation happened until after they've had a chance to rebuild muscle.

(I know that's not what you meant, Neptune. Just expanding your answer.)

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And after two months the weak ones will have already died, but I didn't want to bring that up, since this, apparently, is about one who has made it that far.

But they wouldn't ever get back to the condition they would have been in before starving.

So two months of starvation is pretty serious, but if they get decent enough water intake the rehab won't be that bad. Starvation tends to eat more fat than muscle, so while there is some muscle wasting it's not as bad as it could be. The body starts turning fat into glucose as part of ketosis. This can get really bad and lead to brain damage, but that's fairly rare. Some people put themselves into this state as a dramatic weight loss tool.

After about three days the body starts eating muscle, and that's bad. It can damage your kidneys and immune system. Anyone whose survived on little food for two months will have a compromised immune system, skin issues, probably losing teeth and have picked up some opportunistic infections. When your GI tract doesn't get used C-Diff can get out of control and cause diarrhea, which doesn't really sound bad until you realize that it's the second leading death for children under the age of five. C-Dif can also destroy you intestines by itself.

What's going to happen is that the old and young aren't going to survive very long. Children under eight years old and adults over 60 aren't going to survive long without help. The survivors will mostly be school age to late 30s, depending on what kind of shape they were in before the starvation started.

I can't think of the name, but I want to say there's a book about an American doctor who was the first MD in Dachau, or something like that. He talks about trying to save holocaust victims, that could be useful fo ryou.

Euphoric Mania said:

Thanks for your help.

I woke up this morning with this on my mind, and suddenly thought of Castaway. Remember that movie? Tom Hanks's character spends four years on a deserted island before he's finally rescued. When he gets back, he's properly wasted, but clearly managed to survive on fish and coconuts and who knows what else (I think he actually makes the point that coconut milk is a laxative, and a bad thing in a survival situation... but I may be inserting that from another source.) I dunno what the actor had to do to get that thin, but it does make me wonder how recovering from starvation affects the body's ability to regain muscle tone (if a man who is "ripped" starves and recovers, will he be able to get "ripped" again?)

The places my mind takes me, I swear.

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As I understand it, Tom Hanks did all of the full sized parts of the movie first, the opening and the end piece. Then he spent quite a while losing weight.

When recovering from extreme weight loss, there is a tendency to regain muscle first, so someone with an athletic body will end up with a lean, athletic body while restoring former body weigh. And fat people will also tend to gain muscle before the fat returns.

I know for at least 2 people from one therapeutic group (one man and one woman in their fifties) who were fasting for 45 days, eating nothing, drinking just water and continuing to go to work during all that time. I've seen them before and after: an obvious weight loss and some physical weakness but other than that they appeared healthy. It was voluntary fasting under a doctor's supervision.

The longest period someone has survived without food and without health consequences was 60 + some days (according to what I've heard), but some people would not survive 30 days. 90 days without food does not sound plausible to me.

After the 2010 Haiti earthquake, they rescued a 7 and 8 year old brother and sister after being under the ruins for 7 days without food and water. An old woman (80+) survived for 8 days in some basement after being trapped there without food and water. This is probably about the longest time you can survive without water in ideal circumstances.

Obese people can survive longer without food than the thinner ones but double weight does not means double survival time.

Refeeding syndrome can occur when they give a quick glucose infusion to a severely malnourished person, for example, a chronic alcoholic, which can result in a sudden drop of certain blood minerals and eventually in death. I have not heard about refeeding syndrome from eating. Still, after prolonged starvation one should initially avoid large meals to avoid a potentially dangerous stomach distension.

If you are otherwise healthy, you can start eating foods right away after starvation; it's not that you need an intravenous feeding for few days and then you would start to eat.

Unless a permanent neurological damage has happened, one should recover from starvation completely--regain the previous muscle mass and everything.

Two examples that popped into my mind:

1) The Copiapo mining accident in 2010, where 33 Chilean miners were trapped underground for 17 days. When they were first discovered, they were given a glucose solution to prevent stomach ulcers; solid food followed a few days later. IIRC, there were a few health issues but they were mostly unrelated to the starvation. For example, a couple of men regularly took medicine to lower their blood pressure; after two weeks without the medicine, their BP was high. Also, I don't think there were any long-term health consequences from the experience. Some years ago, I read a book about their experience called "33 Men" by Jonathan Franklin. Highly recommenced.

2) Stephen Callahan, whose sailboat sank early in a journey. He crossed the Atlantic in a raft. Wrote a book about it called "Adrift: 76 days Lost at Sea". He survived on fish and birds that he caught. IIRC, he was eating solid foods again within hours of his rescue.

I suppose those examples don't much help the OP - sorry!

There's no reason why someone couldn't return to their previous weight and muscle strength.

Willpower and motivation may effect recovery times as much as anything. Someone with a strong will and a lot to live for may well be back to normal in a matter of days. Someone without these things may never fully recover. I don't think I've ever heard of a starvation victim dying post-rescue.

Severe dehydration might be another matter.

Euphoric Mania said:

(I think he actually makes the point that coconut milk is a laxative, and a bad thing in a survival situation... but I may be inserting that from another source.)

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I've never seen the movie and have no first-hand experience with Pacific Island survival, but I've always heard that coconuts are an excellent survival food; excellent source of fats, fiber, and sugar. The laxative properties are mild and, unless you're eating NOTHING* but coconuts, shouldn't be a problem for a healthy person.

Coconut water, on the other hand, might not be something you would want to live off of.

*there would be little reason for someone stranded on a desert island to do this. Even if you can't catch fish or crabs, any island capable of supporting palm trees should also have plenty of animal life. A lot of them have wild pigs, and I'd be surprised if there's any that don't have ship rats.